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Note: Carefully read and follow the directions to complete the form and generate a PDF version that can be attached to the final application. All narrative responses and PDF appendices must be submitted as one application.

The Residency Program assures the Commission that if awarded grant funding:
  1. All residents will work at least one-half time alongside a school counselor of record, who is designated as the experienced mentor school counselor, for at least one full school year while engaging in initial preparation coursework. (Appendix A (b)(2))
  2. It is the responsibility of the Commission-approved pupil personnel services preparation program specializing in school counseling offered at the regionally accredited IHE to enroll the candidate in the program and to recommend a resident for the pupil personnel services credential once all requirements have been met.
  3. Grantee LEAs or consortiums agree to prepare residents to become school counselors and eventually be hired in a school within the jurisdiction of the grant recipient.
  4. All residents agree in writing to serve in a school within the jurisdiction of the grant recipient that sponsored the candidate, or another public school in California, for a period of at least four school years beginning with the school year that begins after the candidate successfully completes the initial year of preparation and obtains a pupil personnel services credential. (Appendix A (k))
  5. The LEA and IHE will cooperatively comply with the Commission’s mandated reporting requirements, submitted by stated due dates, including but not limited to:
    1. School Counselor Residency Implementation Grant Program Annual Report. The report template is available upon request. This report is updated every year in the grant reporting cycle.
    2. School Counselor Residency Implementation Grant Program Projections Report. The report template is available upon request. This report provides information for the funding amount for each subsequent year of the grant.
    3. Results from candidate and program graduate surveys of the quality of preparation they received.
    4. Best practices found to be effective in implementing the program.
    5. Factors promoting or hindering residency program implementation.
    6. Lessons learned to inform future investments in school counselor residency programs.
Administrative approval from the Superintendent of the applicant local education agency (LEA)
*It is expected that if the application represents a consortium, ALL LEA partners will each sign an agreement, including partner LEAs within a county office of education.
By signing below, I affirm that:
  1. I have thoroughly read all portions of this application including the assurance statements included on this form.
  2. All statements and data contained in this application are accurate.
  3. If awarded a School Counselor Residency Implementation Grant, the LEA agrees to participation in the activities described as well as the timelines and budgets included in the responses to criterion 1-10 in Section II of this application.



Administrative approval from an authorized administrator of the applicant’s IHE partner(s)
*It is expected that EACH IHE partner will sign an agreement.
By signing below, I affirm that:
  1. I have thoroughly read all portions of this application including the assurance statements included on this form.
  2. All statements and data contained in this application are accurate.
  3. If awarded a School Counselor Residency Implementation Grant, the IHE agrees to participation in the activities described as well as the timelines and budgets included in the responses to criterion 1-10 in Section II of this application.